James Garfield Assassination (Malpractice Conspiracy)

Overview

On July 2, 1881, Charles Guiteau — a mentally unstable, self-described “Stalwart of the Stalwarts” who believed God had personally instructed him to shoot the president — walked up to James A. Garfield at the Baltimore and Potomac Railroad Station in Washington, D.C., and fired two shots with a .44 caliber British Bulldog revolver.

One bullet grazed Garfield’s arm. The other entered his back, traveled past his spine, and lodged behind his pancreas. The president collapsed. He did not die.

He would not die for another 80 days.

What happened during those 80 days is one of the most agonizing stories in American medical history. Garfield’s doctors — led by Dr. Willard Bliss, a physician whose first name was, unbelievably, “Doctor” (his parents named him Doctor Willard Bliss) — spent eleven weeks probing the president’s wound with bare fingers and unsterilized instruments, turning a survivable injury into a death sentence. They expanded a 3.5-inch wound channel to 20 inches. They introduced massive infection into the president’s body. And they rejected, with the confidence of men who have confused stubbornness with expertise, every suggestion that they wash their hands.

Charles Guiteau shot James Garfield. The doctors killed him. This is not a conspiracy theory. It is the medical consensus.

The Shooting

July 2, 1881

Garfield had been president for only four months. He was at the train station to leave for a vacation in New Jersey. His assassin, Charles Guiteau, had been stalking him for weeks — Guiteau had previously purchased a revolver with an ivory handle specifically because he thought it would look better in a museum.

Guiteau fired twice. The first bullet grazed Garfield’s arm — a minor wound. The second entered his back on the right side, about four inches from the spine. The bullet fractured two ribs, passed through the first lumbar vertebra, and lodged in the fatty tissue behind the pancreas.

Garfield was conscious. He was in pain. But the wound, by itself, was not fatal.

The Bullet’s Location

Here is the crucial fact: the bullet that entered Garfield’s back had missed every vital structure. It missed the spine. It missed the spinal cord. It missed the major blood vessels. It missed the kidneys, the liver, and the intestines. It was sitting harmlessly in fatty tissue, where — if left alone — it would have been encapsulated by scar tissue and caused no further harm.

In a modern emergency room, Garfield would have received wound cleaning, antibiotics, and monitoring. He would have walked out of the hospital within a week or two. The bullet might never have been removed. Modern surgical practice often leaves bullets in place when they’re lodged in non-critical locations — removing them creates more risk than leaving them.

But this was 1881, and Dr. Willard Bliss was about to perform medicine on the President of the United States.

The Treatment

Dr. Bliss Takes Charge

Multiple physicians examined Garfield at the train station. Dr. Bliss, a Washington physician with political connections, arrived within minutes and immediately assumed command of the president’s care. He was not Garfield’s personal physician, but he had treated him previously and was assertive enough to elbow out competitors.

Bliss’s first action was to probe the wound with his unwashed finger, trying to locate the bullet. He couldn’t find it. So he inserted a metal probe — also unsterilized — and pushed it into the wound, seeking the bullet. He couldn’t find that either. He then invited other physicians to probe the wound with their fingers as well.

In the first day alone, at least a dozen doctors inserted their unwashed fingers or unsterilized instruments into Garfield’s wound.

The Rejection of Antisepsis

By 1881, the germ theory of disease was well established in Europe. Joseph Lister had published his landmark work on antiseptic surgery in 1867 — fourteen years before Garfield was shot. Lister’s techniques — sterilizing instruments, washing hands, using carbolic acid spray — had dramatically reduced surgical mortality in European hospitals. The evidence was overwhelming.

American medicine was slower to adopt. Many American physicians, including Bliss, were skeptical of Lister’s methods. They considered the idea that invisible organisms could cause infection to be theoretical and unproven. Some viewed antiseptic procedures as an insult to their professional judgment — the implication that their hands were “dirty” was taken as a personal affront.

Bliss was asked about antiseptic techniques during Garfield’s treatment. He dismissed them. “In this country,” he told reporters, “we do not consider it necessary to adopt the Lister method.”

Alexander Graham Bell’s Metal Detector

As the search for the bullet continued, Alexander Graham Bell — yes, the telephone inventor — was brought in to help. Bell had been developing an electromagnetic device that could detect metal objects in the human body, a precursor to the metal detector.

Bell tested his device on Garfield on July 26. The device produced signals, but they were confusing and inconsistent. Bell suspected the problem was the metal-spring mattress Garfield was lying on — a new technology at the time — which was interfering with the device. Bell asked Bliss to move Garfield to a bed without metal springs. Bliss refused.

The device indicated a possible bullet location that conflicted with where Bliss believed the bullet to be. Bliss insisted his assessment was correct. Bell’s invention was declared a failure.

After Garfield’s death, the autopsy revealed that Bell’s device had actually been detecting the bullet correctly. The bullet was nowhere near where Bliss thought it was. Bliss’s repeated probing had been in the wrong direction entirely — creating a new wound channel that ran 20 inches in the wrong direction from the original path.

Eighty Days of Dying

Over 80 days, Garfield’s condition deteriorated steadily:

• The wound became massively infected from the repeated unsterilized probing
• Abscesses formed along the wound tract
• Blood poisoning (septicemia) set in
• Garfield’s weight dropped from 210 pounds to 130 pounds
• He developed bronchopneumonia
• He suffered from delirium and hallucinations

Bliss issued optimistic bulletins throughout, assuring the public that the president was improving even as Garfield was visibly wasting away. The disconnect between Bliss’s public statements and Garfield’s actual condition became a source of dark humor in Washington.

On September 6, at Garfield’s request, he was moved from the White House to a cottage in Elberon, New Jersey, where he hoped the sea air might aid his recovery. A special railroad spur was built overnight to bring his train directly to the cottage — an act of devotion by railroad workers that stands as one of the more touching episodes in presidential history.

It didn’t help. On September 19, 1881, at 10:35 p.m., James Garfield died. He was 49 years old.

The Autopsy

The autopsy confirmed what Bell’s device had suggested and what Bliss had refused to believe: the bullet was lodged behind the pancreas, far from where Bliss had been probing. The wound tract created by the doctors’ instruments was longer and more damaging than the original gunshot wound.

The cause of death was not the bullet. It was sepsis and blood poisoning — infections introduced by the doctors’ unwashed hands and unsterilized instruments.

Guiteau’s Trial

”The Doctors Killed Him”

Charles Guiteau was tried for murder beginning in November 1881. His defense was, in a sense, the first medical malpractice argument in a murder trial. Guiteau acknowledged shooting Garfield but argued that the bullet wound was not fatal — the doctors’ incompetence had killed the president. “I just shot him,” Guiteau said. “His doctors killed him.”

The argument was medically sound. It was also legally irrelevant — under the legal principle that a person is responsible for the foreseeable consequences of their criminal acts, Guiteau was liable for Garfield’s death regardless of the doctors’ contribution. You don’t get to shoot someone and then blame the surgeons when the victim dies.

Guiteau was convicted and hanged on June 30, 1882. At the gallows, he read a poem he had written for the occasion and waved to the audience.

The Conspiracy Angle

Standard Oil and Vice President Arthur

Some conspiracy theories have suggested that Garfield’s medical malpractice was not accidental but deliberate — that powerful interests wanted Garfield dead and either placed Bliss in charge or encouraged his incompetent treatment.

The motive identified is usually political. Garfield had been fighting the “Stalwart” faction of the Republican Party, which was aligned with New York political machines and business interests including Standard Oil. Vice President Chester Arthur was a Stalwart ally of Senator Roscoe Conkling, whose patronage machine Garfield was dismantling.

The theory holds that Arthur or his allies wanted Garfield dead and ensured that incompetent medical treatment would finish the job Guiteau’s bullet had started.

There is no credible evidence for this theory. Bliss was arrogant and wrong, but there is nothing to suggest he was deliberately sabotaging Garfield’s care. His medical approach — reject antisepsis, probe aggressively, search for the bullet — was consistent with mainstream (if outdated) American medical practice of the era. He was incompetent, not malicious.

The real lesson is simpler and more universal: experts who refuse to update their beliefs in the face of new evidence can do as much damage as any conspiracy.

Timeline

Sources & Further Reading

• Millard, Candice. Destiny of the Republic: A Tale of Madness, Medicine and the Murder of a President. Doubleday, 2011.
• Ackerman, Kenneth D. Dark Horse: The Surprise Election and Political Murder of President James A. Garfield. Carroll & Graf, 2003.
• Rutkow, Ira. James A. Garfield. (The American Presidents Series.) Times Books, 2006.
• Lister, Joseph. “On the Antiseptic Principle in the Practice of Surgery.” The Lancet, 1867.

Related Theories

• Lincoln Assassination Conspiracy — Earlier presidential assassination with conspiracy elements
• McKinley Assassination — Later presidential assassination with anarchist connections